Parental experience of transition from a paediatric intensive care unit to a general ward: A qualitative study

Abstract

Aim We aim to explore parental experience in transitioning from a paediatric intensive care unit to a general ward and to investigate parental involvement in caring for their critical illness children. Background Parents have a major responsibility in caring for seriously ill children, but nursing staff fail to meet the expectations of parents regarding nursing care. Few studies have investigated the challenges and needs of Chinese parents during the transition from paediatric intensive care unit to general ward. Methods Semi‐structured interviews were conducted with 24 parents of children with critical illness in a paediatric hospital in Shanghai, mainland China to explore their views. Transcripts were entered into NVivo. Framework analysis was used to analyse the qualitative data. Results Four themes were identified by data analysis: changes in the child during post paediatric intensive care unit periods; experiencing a wide range of emotions; factors involved in the transition; and suggestions for improving transitional care. Conclusions Due to the unmet needs of parents, a more flexible visiting policy and social media support were highly desirable. Getting accurate information, establishing family integrated care, and strengthening ward‐based critical support services were also listed as important needs of parents caring for critically ill children. Implications for Nursing Management A profound understanding of parental experiences during the transitional period can help nursing staff to assess the effects on children and their families, improve ward‐based intensive care, support parental participation, and improve visitation policies. Based on these findings, nurse managers can develop reasonable intervention programmes in order to improve nursing quality and patient outcomes

Pediatricians’ Perspectives on Introducing Transitional Care into Handover Between Pediatric Intensive Care Units and General Wards

“…Hence, follow-up plans should be individualized to cater to the specific needs of each child. 8 , 9 Several PICU doctors in the present study believed that the post-PICU follow-up was impractical due to clinical practice, feasibility, and resources available, while some ward doctors perceived that a comprehensive assessment of the child’s high-risk factors could determine whether follow-up is needed after the PICU stay. Several studies have shown that follow-up visit has a positive impact both on patient outcomes and on the ability of healthcare professionals to improve their transitional care skill.…”

“…In contrast, another study exploring the experiences of parents found that doctors failed to inform parents about post-treatment plans and transition details during discharge. 8 Mueller et al 34 found that shared electronic health records and clear communication chains were considered possible solutions to improve information exchange fidelity. At the same time, shared decision-making helps patients to understand information about the treatment process and can reduce information asymmetry between doctors and patients.…”

“…In the preliminary study, parents of critically ill children also expressed a strong desire to keep in touch with health care professionals. 8 Overall, there should be regular follow-ups with the child’s family after discharge from the hospital via WeChat, which also helps healthcare professionals keep track of the child’s recovery and complications after discharge, so treatment and care can be adjusted accordingly.…”

“…Examining different viewpoints on the challenges and facilitators can unveil novel insights into enhancing the PICU-toward transition, which ultimately leads to better patient care. 27 In previous studies, [8][9][10][11]29 while previous research has explored parents' and nurses' perspectives on transitional care, doctors' views have not been thoroughly investigated. The aim of this research is to identify shortcomings in the delivery of transition care by understanding the perspectives of doctors, which will then have implications for the provision of appropriate training curriculum.…”

“…Numerous national and international studies have evaluated how parents and nurses manage the transition of critically ill children. [8][9][10][11][12] Although the 2009 Transitions of Care Consensus highlighted the crucial role of doctors, 13 there has been limited exploration of doctors' perceptions regarding the care transitions of critically ill children. Additionally, doctors are crucial in ensuring the transfer of information and care responsibility during this period.…”